Radio(chemo)therapie bei älteren Patient:innen mit Kopf-Hals-Tumoren – eine retrospektive Untersuchung zur Erfassung von Einflussfaktoren auf Überleben und Toxizität
von Christoph Patzer
Datum der mündl. Prüfung:2023-11-08
Betreuer:PD Dr. Martin Leu
Gutachter:PD Dr. Martin Leu
Gutachter:PD Dr. Dr. Phillipp Brockmeyer
EnglischLocally advanced head and neck squamous cell carcinoma (HNSCC) is often treated with surgery followed by postoperative radiochemotherapy (RCT). With the general increase in life expectancy, the number of elderly HNSCC patients is expected to rise rapidly. Currently, there is a lack of in-depth understanding of specific management strategies for these elderly patients in clinical practice. This study aimed to compare the treatment outcomes of elderly patients (≥70 years, n=52) and younger patients (<70 years, n=245) who underwent postoperative RCT for HNSCC at our tertiary cancer center. All patients received treatment using modern radiotherapy techniques (IMRT/VMAT). Elderly patients (≥70 years) had a higher prevalence of comorbidities. Additionally, they were less likely to receive concomitant systemic treatment. The incidence of mucositis and dermatitis was lower in patients aged ≥70 years. However, elderly patients experienced significantly worse overall and progression-free survival rates. Locoregional and distant control outcomes were comparable between elderly and younger patients. In conclusion, postoperative RCT remains a safe and effective treatment option for patients aged ≥70 years. Given the presence of comorbidities and the lower overall survival rates, the benefits and risks of radiotherapy and concomitant systemic treatment should be carefully considered. When utilizing state-of-the-art radiotherapy techniques while judiciously employing concomitant systemic therapy, favorable acute toxicity profiles can be achieved.
Keywords: HNSCC; postoperative radiochemotherapy; RCT; elderly; squamous cell carcinoma; comorbidities; toxicity; compliance; IMRT; VMAT